It Happened Here Before It Happened There: The Relevance of the Nazi Analogy
Harvey Berman, PhD, MPH, Associate Professor, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo
The Nazi analogy — the assertion that a modern medical proposal resembles a policy practiced by German physicians during the Holocaust — almost never persuades, almost never clarifies a question, but almost always simplifies the medical grotesqueries of the decade-long Nazi era. Principally, this is because the scope of the Holocaust is without historical precedent. Nazi medicine, appropriating the imprimatur of science, formed the basis of Hitler’s policy to purify the German state through rassenhygiene (racial hygiene), the notion of perfection of humankind through selective reproduction, sterilization, and ultimately destruction of “undesirables” deemed worthy of elimination: Jews, gypsies, and Slavs, the mentally ill, physically disabled, people with epilepsy and Down Syndrome, homosexuals, criminals, and any voices of conscience against the racial policy of the Nazi state. Thousands of physicians, nurses, scientists, and technicians, working in hundreds of concentration camps across Europe, used unwilling prisoners as experimental subjects in the most inhumane and monstrous medical procedures.
Modern-day emerging techniques of prenatal diagnosis and the increasing capacity to manipulate human genetics present a case to be made for questioning whether medical interference in reproduction shares some facets associated with Nazi racial hygiene, whether these modern practices represent a form of eugenics, and whether the current cultural and political milieu that rushes to adopt these technologies does so uncritically, with little reflection or consideration of unintended consequences.
An increasing number of jurisdictions in the United States, for example, have implemented legislation allowing physician assistance in suicide, the abortion of fetuses with disabilities, and even infanticide. Moreover, parents carry a “moral obligation”, says Julian Savulescu among others, to use science and technology to select the “best child” possible, that indeed science is to be employed, no differently than in the racial state envisioned by Hitler, to “improve [our] biology.” Thus, physicians are to be importuned to forfeit their rights to conscientious objection and to conform their behaviour with the new legislation, overriding their Hippocratic Oath.
The current zeitgeist has implications concerning the intention of prenatal testing, how far one can and should expand the limits of reproductive freedom, and the moral worth of individuals living with—or those who might be born with—disabilities. Racial hygiene was not unique to Hitler, and may nations, principally the United States 100 years ago, provided a model for eugenic interventions, many times enforced upon the victim. This short talk will ask whether American medicine as it is expressed today, with an array of reproductive technologies and the burgeoning accessibility of assisted suicide and euthanasia, mimics eugenic intentions of the Nazi era. Or, rather, are these merely isolated techniques that allow for individual selection of particular genetic characteristics and decisions of when a life should go no further. This talk strikes a cautionary note: unthinking dismissal of the Nazi analogy may lead to unthinking dismissal of important questions.
Modern-day emerging techniques of prenatal diagnosis and the increasing capacity to manipulate human genetics present a case to be made for questioning whether medical interference in reproduction shares some facets associated with Nazi racial hygiene, whether these modern practices represent a form of eugenics, and whether the current cultural and political milieu that rushes to adopt these technologies does so uncritically, with little reflection or consideration of unintended consequences.
An increasing number of jurisdictions in the United States, for example, have implemented legislation allowing physician assistance in suicide, the abortion of fetuses with disabilities, and even infanticide. Moreover, parents carry a “moral obligation”, says Julian Savulescu among others, to use science and technology to select the “best child” possible, that indeed science is to be employed, no differently than in the racial state envisioned by Hitler, to “improve [our] biology.” Thus, physicians are to be importuned to forfeit their rights to conscientious objection and to conform their behaviour with the new legislation, overriding their Hippocratic Oath.
The current zeitgeist has implications concerning the intention of prenatal testing, how far one can and should expand the limits of reproductive freedom, and the moral worth of individuals living with—or those who might be born with—disabilities. Racial hygiene was not unique to Hitler, and may nations, principally the United States 100 years ago, provided a model for eugenic interventions, many times enforced upon the victim. This short talk will ask whether American medicine as it is expressed today, with an array of reproductive technologies and the burgeoning accessibility of assisted suicide and euthanasia, mimics eugenic intentions of the Nazi era. Or, rather, are these merely isolated techniques that allow for individual selection of particular genetic characteristics and decisions of when a life should go no further. This talk strikes a cautionary note: unthinking dismissal of the Nazi analogy may lead to unthinking dismissal of important questions.